Active NPI
Scott Krueger, RD
- Registered Dietitian
- Keshena, WI
National Provider Identifier
1306113873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 820
- Practice address
- W3275 Wolf River Road
Keshena, WI 54135-0970 - Phone
- (715) 799-5443
- Fax
- (715) 799-3099
- NPI assigned
- Nov 28, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 820 | WI | Primary |
Addresses
Primary practice location
W3275 Wolf River Road
Keshena, WI 54135-0970
Mailing address
PO Box 970
W3275 Wolf River Road
Keshena, WI 54135-0970
Phone (715) 799-5443
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 820 | WI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322438400000",
"number": "1306113873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 970",
"address_2": "W3275 WOLF RIVER ROAD",
"city": "KESHENA",
"state": "WI",
"postal_code": "541350970",
"telephone_number": "715-799-5443",
"fax_number": "715-799-3099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W3275 WOLF RIVER ROAD",
"city": "KESHENA",
"state": "WI",
"postal_code": "541350970",
"telephone_number": "715-799-5443",
"fax_number": "715-799-3099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUEGER",
"first_name": "SCOTT",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-28",
"last_updated": "2011-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Keshena, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.